CONTENTS | ANB-BIA HOMEPAGE | WEEKLY NEWS
by Isaac Nyangeri, Kenya, October 1998
THEME = AIDS
AIDS exists in Kenya and
rightly gives cause for concern.
But what are the facts behind this dread disease?
It is projected that the number of deaths in Kenya due to AIDS, among people aged between 15-39 and covering the period 1995-2000, will possibly be three times the number of deaths due to all other diseases combined, in that same period.
In 1995, it was reported to be the number one killer among people in the 15-39 age-bracket in sub-saharan Africa
The first AIDS case in Kenya was reported in 1984, five years after the first case worldwide was reported in the United States (1979). The current estimate of people in Kenya infected with AIDS, is about 1.4 million and is expected to reach 1.7 million by the year 2000. Since 1990, the average cases reported per year is 12,000, with approximations putting the estimate three times higher.
The AIDS epidemic is more advanced in Nyanza, Western and parts of Rift Valley provinces where prevalence rates among pregnant women are 18%-30%. Up to 90% of AIDS cases are transmitted through sexual contact, heterosexuality being the most common reason. In Coast Province, which is also high on the list (indeed it used to be the leading province), homosexuality cannot be ruled out.
Ignorance: Many people are not aware of the true cause of the disease, hence victims are in some instances, misconstrued to have transgressed some society norms resulting in their suffering. Poverty: This leads to practices such as prostitution. Socio-cultural beliefs and practices: Especially those that include tooth extraction, circumcision, skin piercing, scarification and blood-letting practices. Labour migration: Beach-boys, watchmen, soldiers, prisoners and long- distance truck drivers are all at risk because of separation from regular partners. Other factors include: Lack of proper health infrastructures; risk taking in sexual behaviour(especially among men); abuse in alcohol leading to over-indulgence in sexual practices.
Apart from those mentioned above who, because of their situation are separated from their regular partners, there are other categories of people reckoned to be at risk:
Women are vulnerable because of their lower status in society. They are exposed to sexual abuse by others and thus to AIDS. Adolescents are at risk because of biological, socio- cultural and economic factors that leave them open to sexual experimentation with others. The problem is worsened by the difficulty in discussing sexual issues with adults (e.g.their parents). Young adults: Figures speak for themselves. Data from the National AIDS Control Programme shows that the peak years for AIDS are between 20-25 years for females and 25-35 years for males. And 60% of Kenya's population is under 20! Also, many of Kenya's children are born with the HIV virus because one or both of their parents had AIDS.
Because of AIDS, Kenya's economy is affected in a number of ways, particularly a serious loss in workforce numbers resulting in the country's economic decline. Caring for AIDS sufferers is very expensive. The average direct cost per new case is approximately Kenya Shillings 34,680, assuming that 55% of AIDS patients receive hospital treatment. Also, caring for people with opportunist infections (that occur as a result of HIV/AIDS) is also not cheap. The HIV virus has caused a major resurgence of tuberculosis, creating a great public health problem particularly with the emergence of drug resistant forms of tubercle bacilli. The cost of treatment is about 700,000 shillings per person per year.
High prevalence rates in men and women of reproductive age, results in relatively high prevalence rates among new born infants. There is a high mortality rate among infected infants. A number of people are involved in the prevention and control of AIDS, with the government playing an important role.
In 1985, the government established The National AIDS Committee. The AIDS Programme Secretariat (APS) was created within the office of the Director of Medical Services to co-ordinate programme activities. The Kenya National AIDS Control Programme was formed in 1987, followed by the development of five-year strategic plans divided into two sections.
The First Medium Term Plan (1987-1991) emphasised creating awareness about AIDS. The main strategies pursued were aimed at preventing the transmission of AIDS through sexual intercourse, through using contaminated blood, through mother to child transmission. The plan was also occupied with disease surveillance (where infections are monitored at a local/district level).
The Second Medium Term Plan (1992-1996) continued to pursue the same strategies, emphasising the need to involve all sectors in preventing HIV infection and providing care and special support to people infected with AIDS/HIV. The government also devoted a whole chapter on AIDS in the Seventh National Development Plan.
A number of Non-Governmental Organisations (NGO)s are also involved in creating AIDS awareness.
The Association of People with AIDS in Kenya (TAPWAK) is a charitable organisation, established in July 1990 by fifteen persons with AIDS (PWA) as a forum for addressing their health problems. It was registered in September 1992 and formerly launched on 1 December 1992. Positive Women of TAPWAK (POWOTA) is a movement within TAPWAK, which aims at empowering its women members. TAPWAK also has an orphans project which assesses the problems and needs of AIDS orphans and seeks solutions. (Many of Kenya's children are orphans of AIDS victims).
The Voluntary Women Rehabilitation Institute (VOWRI) offers advice and training for alternative employment, to "commercial" sex workers. According to Dr.Elizabeth Ngugi, founder member and director of the Institute, some prostitutes have already been rehabilitated, including children. 17-year old Lucy Wanjiry was introduced to commercial sex by a friend at the tender age of 13, and engaged in that "trade" for four years before being rehabilitated with VOWRI's help.
Emphasis has been placed on awareness campaigns. There are a lot of free leaflets on offer in public places. There are also a number of programmes presented over the radio in different languages.
All the above programmes, however, seem to focus most of their attention at publicising the use of condoms, which are available on request even in libraries. It is here that different religious organisations play a pivotal role. In addition to setting up groups for helping AIDS victims, their teachings discourage factors contributing to AIDS, like pre-marital sex. They are also very helpful in bringing AIDS awareness programmes down to the local level, especially in rural areas. Other groups are largely urban-centred, whereas it is well known that AIDS sufferers tend to return to their respective rural areas. It is therefore the rural folk who need to know about caring for AIDS patients since they return to die in the rural areas.
There is still a great deal of secrecy about the actual number of those diagnosed as having AIDS, and the way in which the diagnosis is carried out. According to one doctor, there is no way of determining who has AIDS unless blood tests are carried out. This test has to be done twice, three months apart - i.e. the time it takes for the eraser to show the presence of antibodies from the time of infection.
But not everybody's blood has been tested so how can accurate figures be determined?
Clinical signs and symptoms of AIDS vary a lot. Infection by "opportunist" intracellular germs, which are usually destroyed by the immunity defense mechanism in a normal person, is the cause of AIDS. Major clinical signs of a sick person would be two of the following: Chronic diarrhoea exceeding one month; bodyweight loss of more than 10%; fever of unknown origin which persists for over a month. And then one of the following signs: Chronic cough; skin eruptions (herpes zoster), a cutaneous skin rash; oral thrash that extends to the digestive tube (sign of low immunity); cutaneous ulceration and itching around the perianal and genital areas due to herpes; swelling of the lymph glands.
The fact is, AIDS is here with us, but it is not the only (or even the most dreadful) killer disease and there is certainly a great deal of misunderstanding and sensationalism. Nevertheless, in order to overcome the challenges posed by AIDS, a strong political commitment at the highest level, implementation of a multi-sectoral AIDS prevention and control strategy with priority focus on young people, mobilisation of resources for funding HIV prevention, care and support, and the establishment of a National AIDS Council to provide leadership at the highest level possible, are critical. (cf.Seventh National Development Plan - Session Paper number 4, 1997, on "AIDS in Kenya").
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CONTENTS | ANB-BIA HOMEPAGE | WEEKLY NEWS
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